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HelpTest ID TBIDS Culture Referred for Identification, Mycobacterium and Nocardia with Antimicrobial Susceptibility Testing, Varies
Infectious
Shipping Instructions
1. See Infectious Specimen Shipping Guidelines in Special Instructions for shipping information.
2. Place specimen in a large infectious container (T146) and label as an etiologic agent/infectious substance.
Necessary Information
1. Specimen source is required.
2. Isolate description is required: Gram stain reaction, morphology, tests performed.
Specimen Required
Specimen Type: Organism in pure culture
Supplies: Infectious Container, Large (T146)
Container/Tube: Middlebrook (7H10 or 7H11) or Lowenstein-Jensen medium slant or in broth (eg, Mycobacteria Growth Indicator Tube [7H9] broth)
Specimen Volume: Isolate
Collection Instructions: Organism must be in pure culture, actively growing. Do not submit mixed cultures.
Forms
If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.
Secondary ID
64714Useful For
Rapid identification to the species level and susceptibility testing for Mycobacterium species, Nocardia species, and other aerobic actinomycete genera and species from pure culture isolates
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| RMALM | Id MALDI-TOF Mass Spec AFB | No, (Bill Only) | No |
| RTBSP | Id, Mtb Speciation, PCR | No, (Bill Only) | No |
| TBMP | Mycobacteria Probe Ident | No, (Bill Only) | No |
| TBPB | Mycobacteria Probe Ident Broth | No, (Bill Only) | No |
| ISMY | ID by 16S Sequencing | No, (Bill Only) | No |
| SRG | Susceptibility Rapid Grower | No, (Bill Only) | No |
| RSLG | Susceptibility Slow Grower | No, (Bill Only) | No |
| SSNS | Susceptibility Nocardia species | No, (Bill Only) | No |
| STV1 | Susceptibility, Mtb Complex, Broth | No, (Bill Only) | No |
| STV2 | Susceptibility, Mtb Cx, 2nd Line | No, (Bill Only) | No |
| STVP | Susceptibility, Mtb Complex, PZA | No, (Bill Only) | No |
| MTBVP | Mtb PZA Confirmation, pnc A Sequence | No, (Bill Only) | No |
| MIC | Susceptibility, MIC | No, (Bill Only) | No |
| LCTB | Id, MTB complex Rapid PCR | No, (Bill Only) | No |
Testing Algorithm
When this test is ordered, the reflex antimicrobial susceptibility test will be performed at an additional charge. All mycobacteria and Nocardia (including aerobic actinomycetes) submitted will be identified and billed as appropriate.
Nucleic acid probes used for identification, when applicable, include those for Mycobacterium avium-intracellulare complex, Mycobacterium gordonae, and Mycobacterium tuberculosis complex. Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI TOF MS) and/or 16S rDNA sequencing is used for identification, when applicable, for slowly and rapidly growing Mycobacterium species and aerobic actinomycetes (including Nocardia species and Streptomyces species). The M tuberculosis complex can be further identified to the species level upon request, using a separate rapid PCR test. Minimum inhibitory concentration (MIC) determination by either the microtiter broth dilution method or critical concentration testing by broth dilution will be automatically performed as appropriate after species identification.
See Culture Referred for Identification and Susceptibility for Mycobacterium and Nocardia Algorithm in Special Instructions.
Special Instructions
Method Name
Nucleic Acid Probe/16S rDNA Sequencing/Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry (MALDI TOF MS)/Rapid Polymerase Chain Reaction (PCR)
Reporting Name
Mycobacteria Culture Refer ID+SuscSpecimen Type
VariesSpecimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Varies | Ambient (preferred) | |
| Refrigerated | ||
Clinical Information
There are nearly 200 recognized species of mycobacteria and more than 100 Nocardia species. Many are human pathogens and, therefore, identification to the species level is important to help guide patient care. In addition, there are other aerobic actinomycete genera that can be human pathogens including, but not limited to, Tsukamurella, Rhodococcus, and Gordonia species.
Nucleic acid hybridization probes are utilized that identify specific ribosomal RNA sequences of Mycobacterium tuberculosis complex, Mycobacterium avium complex, and Mycobacterium gordonae. Other Mycobacteria species, Nocardia species, and other aerobic actinomycete genera are identified using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI TOF MS) or nucleic acid sequencing of a 500-base pair region of the 16S ribosomal RNA gene.
After identification, antimicrobial susceptibility testing is performed following Clinical and Laboratory Standards Institute (CLSI) M24 guidelines using either broth dilution or critical concentration methods as appropriate for the species.
Reference Values
Not applicable
Cautions
If the organism is received in mixed culture or contaminated, the report may be delayed or identification may not be possible.
Day(s) Performed
Monday through Sunday
Report Available
60 to 70 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
Culture Referred for Identification, Mycobacterium
87118-Identificaiton of mycobacteria
87158-Identification of mycobacteria by other methods (if appropriate)
87118 -Id MALDI-TOF Mass Spec AFB (if appropriate)
87153-Mycobacteria Identification by Sequencing (if appropriate)
87150-Mycobacteria Probe Ident, Solid (if appropriate)
87150-Mycobacteria Probe Ident, Broth (if appropriate)
87150-Id, Mtb Speciation, PCR (if appropriate)
87186-Susceptibility Rapid Grower (if appropriate)
87186-Susceptibility Slow Grower (if appropriate)
87186-Susceptibility Nocardia species (if appropriate)
87188 x 3-Antimicrobial Susceptibility, Mycobacterium tuberculosis Complex, Broth Method (if appropriate)
87186-Suscetpbility, Mtb Cx, 2nd Line (if appropriate)
87188-Susceptibility, Mycobacterium tuberculosis Complex, Pyrazinamide (if appropriate)
87153-Mtb PZA Confirmation, pncA Sequencing (if appropriate)
87150- Id, MTB complex Rapid PCR (if appropriate)